How does bradykinin cause angioedema?

Currently, we distinguish 5 types of nonallergic angioedema: hereditary angioedema (HAE) due to C1-INH deficiency, acquired angioedema (AAE), and angioedema induced by the renin-angiotensin-aldosterone system, all of which are mediated by bradykinin, as well as pseudoallergic angioedema and idiopathic angioedema.

What is the main cause of angioedema?

Allergies. Angioedema is often the result of an allergic reaction. This is where the body mistakes a harmless substance, such as a certain food, for something dangerous. It releases chemicals into the body to attack the substance, which cause the skin to swell.

What causes increased bradykinin?

A class of drugs called angiotensin converting enzyme inhibitors (ACE inhibitors) increase bradykinin levels by inhibiting its degradation, thereby increasing its blood pressure lowering effect. ACE inhibitors are FDA approved for the treatment of hypertension and heart failure.

What type of hypersensitivity is angioedema?

Histamine-mediated or allergic angioedema occurs through a type I IgE-mediated hypersensitivity immune response, which is largely mast cell-dependent.

What is bradykinin-mediated angioedema?

Bradykinin-mediated angioedema is a rare disease, due to vasodilation and increased vascular permeability resulting from bradykinin. This kind of angioedema affects abdominal and/or upper airways. It differs clinically from histamine-mediated angioedema by the absence of urticaria or skin rash.

Does bradykinin cause inflammation?

Bradykinin is involved in plasma extravasation, bronchoconstriction, nociception, vasodilation, and inflammation Burch et al (1990). It mediates inflammation by causing vasodilation, by increasing vascular permeability, and by stimulating the synthesis of prostaglandins.

Who is most at risk for angioedema?

Significant risk factors for severe cases of angioedema included older age, Hispanic race, ACEi-induced angioedema type, American Society of Anesthesiologists class III or above, coexistent cardiopulmonary disease, and a positive smoking history.

What is bradykinin cough?

A local accumulation of bradykinin may lead to activation of pro-inflammatory peptides (e.g. substance P, neuropeptide Y) and a local release of histamine. This may also cause cough reflex hypersensitivity.

What stimulates bradykinin release?

Bradykinin, a biologically active peptide, is released by the breakdown of a high molecular weight kininogen by kallikreins Altamura et al (1999). Bradykinin causes pain by directly stimulating primary sensory neurons and provoking the release of substance P, neurokinin, and calcitonin gene-related peptide.

What is bradykinin mediated angioedema?

How long does bradykinin last?

Repeated exposure of preconstricted porcine coronary arteries to bradykinin produced progressively smaller responses (Figure 2, n=5). Its effects lasted less than 10 min, and contractility returned to preconstriction level within 15–20 min.

Does bradykinin mediate the pathophysiology of angioedema?

Some types of angioedema may be mediated by bradykinin. We measured plasma levels of bradykinin-(1-9)nonapeptide by radioimmunoassay after high-performance liquid chromatography in patients with different types of angioedema durin … Angioedema has different causes and different clinical presentations.

Why do angiotensin-converting enzymes cause bradykinin formation?

Although each of these causes excessive bradykinin formation because of activation of the plasma bradykinin-forming pathway, the angioedema due to angiotensin-converting enzyme inhibitors is caused by excessive bradykinin levels due to inhibition of bradykinin degradation.

What are normal levels of bradykinin in patients with C1-inhibitor deficiency?

Eleven patients with the deficiency of C1-inhibitor had very high levels of bradykinin during acute attacks of angioedema (18.0-90.0 pM) (normal range 0.2-7.1 pM).

What are the types of nonallergic angioedema (HAE)?